Lipid-rich carotid artery plaques appear echolucent on ultrasound B-mode images and may be associated with intraplaque haemorrhage.
OBJECTIVE
To relate the histological composition of carotid artery plaques with morphology as evaluated by B-mode ultrasound.


METHODS
Prospective study.


METHODS
Seventy-eight symptomatic patients underwent carotid endarterectomy after preoperative ultrasound Duplex scanning evaluating plaque morphology. Morphometric analysis of the removed specimen was performed in order to quantify content of lipid, haemorrhage, calcification and fibrous tissue.


RESULTS
Echolucent plaques contained more lipid (p = 0.01) and less calcification (p = 0.01) and fibrous tissue (p = 0.03) than echo-rich plaques. Intraplaque haemorrhage was directly related to lipid content (p = 0.004) and inversely related to amount of fibrous tissue in the plaque (p = 0.02).


CONCLUSIONS
The intensity of the reflected B-mode ultrasound signal appears related to the histological composition of the plaque. The association between intraplaque haemorrhage and a high lipid content may support the theory of the lipid-rich plaque being more prone to rupture.
Grønholdt
M L
ML
Department of Vascular Surgery, University Hospital of Copenhagen, Rigshospitalet, Denmark.
Wiebe
B M
BM
Laursen
H
H
Nielsen
T G
TG
Schroeder
T V
TV
Sillesen
H
H
D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D014463:Ultrasonography
D008055:Lipids; D008074:Lipoproteins